Dental
Great Lakes Pediatric Dentistry PLLC
Great Lakes Pediatric Dentistry PLLC was paid $4.88M by Medicaid between Jul 2018 and Dec 2024, across 26 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 36% of everything it billed.
33Billing provider infoGREAT LAKES PEDIATRIC DENTISTRY PLLC
FERGUS FALLS, MN 56537
FERGUS FALLS, MN 56537
33aNPI1144726506assigned 04/04/2018
33bProvider typePediatric Dentist
28Total paid$4.88M
24GClaims71,911
24DCodes billed26
24AFirst – last monthJul 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Minnesota
Rank by total paid#6 of 49
Median peer was paid$94K
This provider vs. median52×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 710 | $25K | |
| 2019 | 8,119 | $454K | |
| 2020 | 7,941 | $445K | |
| 2021 | 10,620 | $591K | |
| 2022 | 12,843 | $908K | |
| 2023 | 16,041 | $1.25M | |
| 2024incomplete | 15,637 | $1.20M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 36% | 9,591 | 2,959 | $1.74M |
| D1120 | Dental cleaning, childProphylaxis - child | 9.6% | 10,347 | 10,264 | $467K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 9.2% | 10,183 | 10,108 | $448K |
| D1206 | Topical application of fluoride varnish | 7.9% | 11,503 | 11,417 | $384K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 6.7% | 3,154 | 1,489 | $326K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.9% | 3,587 | 1,845 | $288K |
| D7140 | Extraction, erupted tooth or exposed root | 5.2% | 2,371 | 1,409 | $254K |
| D0272 | Bitewings - two radiographic images | 3.3% | 3,948 | 3,926 | $161K |
| D1351 | Sealant - per tooth | 2.6% | 3,084 | 975 | $128K |
| D0140 | Limited oral evaluation - problem focused | 2.4% | 2,141 | 2,122 | $119K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.4% | 5,291 | 4,955 | $118K |
| D1110 | Prophylaxis - adult | 1.6% | 1,129 | 1,126 | $79K |
14 more codes
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 1.6% | 728 | $76K |
| D2934 | 1.5% | 221 | $75K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.3% | 1,052 | $61K |
| D1510 | <1% | 245 | $49K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 1,341 | $24K |
| D0274 | Bitewings - four radiographic images | <1% | 348 | $21K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 867 | $20K |
| D0240 | <1% | 526 | $13K | |
| D3230 | <1% | 34 | $6K | |
| D1330 | <1% | 119 | $5K | |
| D2330 | <1% | 47 | $4K | |
| D0330 | Panoramic radiographic image | <1% | 26 | $3K |
| D2332 | <1% | 16 | $2K | |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 12 | $330.84 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialSTEINMETZ, MICHAEL (OWNER)